Cases  1  2 3 4 5 Diagnosis DPU Cold urticaria DPU SU DPU DPU Cold urticaria Duration 14yrs Worse from 2011 Years worse >2yrs 1-2 yrs 10yrs 1 yr Age(sex) 44(f) 63(f) 71 (F) 47(F) 19(F) Ethic Group Caucasian Caucasian Caucasian Afrocarribean Caucasian Atopic Yes HDM Yes Airborne Wheat Yes HDM Sulphite reactions Yes Grass, tree, HDM, nuts, banana, yeast Yes Wheat banana Other conditions Nil Irritable bowel syndrone Hypertension Lichen planus Past immunotherapy 1948 and 1974 Hypertension Seasonal asthma Steroid-induced psychosis Eczema Chronic urticaria no no yes yes no Acute urticaria Viruses Eggs penicillin Aspirin Grass pollen Solar UVA (380-400 nm) Grass pollen banana Previous treatment Steroids Cetirizine Loratidine montelukast Cetirizine Montelukast Steroids Candesartan Moduretic Omeprazole nifedipine Cetirizine/ fexofenadine Total UV block creams Prednisolone Ranitidine Montelukast Phenergan Chlorpheniramine Eurax cream Assorted H2 Antihistamines Cetirizine, loratidine Loratidine Prednisolone montelukast Routine and immune blood tests+ normal Normal Normal á IgE HDM Normal á IgE grass normal 25OH Vitamin D at referral nmol/l* 30 44 48 43 Not measured Vitamin D dose commenced 5000 IU/day 2000 IU/day 2000 IU/day 4000 IU/day 2000 IU/day Time to improvement 2 months 4 months 3 months 4 months 2 months Outcome Resolved to DPU, cold and viral illness DPU Resolved Vitamin D SU Resolved All drugs and creams stopped No clothing Protection needed Resolved All drugs stopped Remaining mild DPU on fingers only Follow-up/ relapses 2 and 6 month. none 2 yr Resolved as long as she stays on vitamin D 4 yrs Resolved and holiday in California gave no problems 3 yrs 3 years and stable without symptoms * <20 nmol/l: severe deficiency 20-50 nmol/l: insufficiency 50-200 nmol/l: replete + blood count, liver and kidney function, thyroid, protein and calcium levels, C-reactive protein, complement and auto-antibodies,ANCA,C3,C4,C1assay and function

Table 1: Case Summary.

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